Abstract
We report significant hypotension and prerenal failure in an extremely preterm infant following two doses of oral sildenafil that warranted discontinuation of the drug and treatment with inotropes. Blood pressure and urine output normalized after 24 h of withdrawal of the oral drug. Sildenafil should be used cautiously in extremely preterm infants early in the neonatal course, where there is limited data on its efficacy and safety.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Shah PS, Ohlsson A . Sildenafil for pulmonary hypertension in neonates. Cochrane Database Syst Rev 2011; 10: CD005494.
Cavallaro G, Agazzani E, Andaloro L, Bottura C, Cristofori G, Mussini P et al. [Sildenafil and nitric oxide inhalation in neonatal pulmonary hypertension. Three case reports]. Pediatr Med Chir 2008; 30: 149–155.
Namachivayam P, Theilen U, Butt WW, Cooper SM, Penny DJ, Shekerdemian LS . Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children. Am J Respir Crit Care Med 2006; 174: 1042–1047.
Konig K, Barfield CP, Guy KJ, Drew SM, Andersen CC . The effect of sildenafil on evolving bronchopulmonary dysplasia in extremely preterm infants: a randomised controlled pilot study. J Matern Fetal Neonatal Med 2014; 27: 439–444.
Barst RJ, Beghetti M, Pulido T, Layton G, Konourina I, Zhang M et al. STARTS-2: long-term survival with oral sildenafil monotherapy in treatment-naive pediatric pulmonary arterial hypertension. Circulation 2014; 129: 1914–1923.
Mukherjee A, Dombi T, Wittke B, Lalonde R . Population pharmacokinetics of sildenafil in term neonates: evidence of rapid maturation of metabolic clearance in the early postnatal period. Clin Pharmacol Ther 2009; 85: 56–63.
Ahsman MJ, Witjes BC, Wildschut ED, Sluiter I, Vulto AG, Tibboel D et al. Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube. Arch Dis Child Fetal Neonatal Ed 2010; 95: F109–F114.
Wardle AJ, Wardle R, Luyt K, Tulloh R . The utility of sildenafil in pulmonary hypertension: a focus on bronchopulmonary dysplasia. Arch Dis Child 2013; 98: 613–617.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest
Rights and permissions
About this article
Cite this article
Balasubramanian, H., Strunk, T. & Kohan, R. Arterial hypotension and prerenal failure in an extremely preterm infant associated with oral sildenafil. J Perinatol 35, 458–459 (2015). https://doi.org/10.1038/jp.2015.31
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2015.31
This article is cited by
-
Controversies in the identification and management of acute pulmonary hypertension in preterm neonates
Pediatric Research (2017)
-
Sildenafil
Reactions Weekly (2015)